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Research Into Language-Based Equity in African Health Science Research

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Research Into Language-Based Equity in African Health Science Research Research into language-based equity in African health science research Aaron N. Yarmoshuk, PhD (Lead) Doreen Mloka, PhD Sounan Fidèle Touré, MD, MPH Vandana Sharma, MD, MPH Samuel Wanji, PhD May 2021 This research was funded by Wellcome Research project team Aaron N. Yarmoshuk, PhD, Dalla Lana School of Public Health, University of Toronto (Canada) Doreen Mloka, Muhimbili PhD, University of Health and Allied Sciences (Tanzania) Sounan Fidèle Touré, MD, MPH, Université Alassane Ouattara (Côte d’Ivoire) Vandana Sharma, MD, MPH, Harvard T.H. Chan School of Public Health (United States of America) Samuel Wanji, PhD, University of Buea and REFOTDE (Cameroon) Dr. Yarmoshuk can be reached at [email protected]. Note regarding final report The official version of the final report of Research into language-based equity in African health science research is the English version. The final report has been translated into Arabic, French, Portuguese and Swahili to reach out to more health science researchers across the continent and to encourage youth and young researchers in Africa who speak these languages to pursue their health science research dreams. Only the English version includes the annexes. All versions (Arabic, English, French Portuguese and Swahili) of the final report and the 2-page policy brief are available at www.hppafrica.org. Translators of Final Report Madalena Lobo Antunes and José Bernardino – Portuguese Ahmed Hamdy - Arabic Ali Hassani Selemani - Swahili Clément Sédack – French Acknowledgements This research was funded by Wellcome. We thank all study participants for their time and contributions. We thank David Zakus (Canada) for reviewing various drafts of the report. Cover Photo The photo is of the sculpture, Ending and Beginning, by David Hlongwane, winner of the University of the Western Cape (UWC) public sculpture competition in 1994. The photo was chosen to celebrate African art and change in South Africa. The sculpture features in Minty, Z., CHAPTER 6: PUBLIC ART PROJECTS IN POST- APARTHEID SOUTH AFRICA Visual culture, creative spaces and postcolonial geographies, in The Visual Century: South African Art in Context 1907 to 2007, G. Jantjes, et al., Editors. 2011, Wits University Press: Johannesburg, South Africa. The photo was provided by University of the Western Cape (South Africa). Suggested citation: Yarmoshuk, A.N., et al., Research into language-based equity in African health science research. 2021, The Wellcome Trust: London, UK. © The Wellcome Trust This report is licenced under a CC BY attribution licence - https://creativecommons.org/licenses/by/4.0/. Report design: themediachilli, Cape Town (South Africa) – [email protected] This research was funded by Wellcome 2 Table of Contents List of Acronyms ......................................................................................................................................................4 Executive Summary ................................................................................................................................................5 1. Introduction .....................................................................................................................................................7 2. Background .....................................................................................................................................................7 3. Methods ...........................................................................................................................................................8 Map 1 – Participation of African representatives in study, key informant interviewees (Sample 1) and questionnaire respondents (Sample 2) ...........................................................................................9 4. Findings ..........................................................................................................................................................10 4.1 Language Issues Identified ....................................................................................................................10 4.2 Non-language issues that intersect with language and potentially contribute to structural inequalities within the health science research ecosystem, .........................................13 5. Interpretation of Findings by Objective .....................................................................................................16 6. Key Recommendations .................................................................................................................................21 7. Strengths, Limitations and Areas for Further Research.............................................................................22 References .............................................................................................................................................................24 Annexes A. Table of African countries with key indicators for this study sorted by publications by medical sciences in 2014 ..........................................................................................................................27 B. List of study participants, Samples, 1, 2 and 3 .............................................................................................29 C. Detailed Methods ...........................................................................................................................................31 D. Study Team Composition ...............................................................................................................................46 List of Acronyms AAAQ Availability, Accessibility, Acceptability and Quality AAS African Academy of Sciences AU African Union EARIMA Eastern African Research and Innovations Management Association IDRC International Development Research Centre KI key informant MENAWCA Middle East and North Africa Writing Centres SARIMA Southern African Research and Innovation Management Association WHO-AFR World Health Organization African Region WHO-EMR World Health Organization Eastern Mediterranean Region WHO World Health Organization 4 Research into language-based equity in Africa health science research Executive Summary Wellcome commissioned this study to examine a critical barrier to developing a more inclusive pan- African research ecosystem, enabling a greater diversity of research talent to contribute knowledge and be heard. The overall objective of the project is to identify actual and perceived language and intersectional barriers (e.g. gender, institutional, individual, attitudinal, economic, financial) facing African health science researchers in the short- and longer-term that constrain cross-language understanding and participation in all aspects of the research endeavour. This study has three specific objectives: 1. To examine whether the use of English, in the African context, is a barrier to the advancement and success of health science researchers either individually, nationally or internationally, and to the advancement of health science more widely in Africa. 2. To examine whether the use of English, in the African context, is contributing to wider structural inequalities within the general health science research ecosystem. 3. To recommend practical solutions to addressing concerns identified. A mixed method approach, employing both qualitative and quantitative data collection, was used. Ninety-five articles, including peer-reviewed and grey literature, were systematically analysed. Sixty-four individuals – 48 Africans and 16 non-Africans – participated in the study by being interviewed as key informants (45) or by completing questionnaires (19). The participants came from 18 African countries and 6 non-African countries. The principal language of instruction of medical schools in the countries in which the key informants were based were: English, six; French, six: Portuguese, two; French/English, one; and English/Arabic, one. interviews were conducted in the language of choice of the interviewees. The qualitative data were analysed using a grounded theory approach. The findings were triangulated with the literature analysed. The study has 15 findings. They are grouped by: i) language related findings; and ii) non-language related finding. The key findings related to language include the following. • There are a multitude of languages used for health science education, research and service delivery in Africa. • Academic language is a language unto itself. • English is currently the dominant language used within health science research. • There are advantages and disadvantages of English being the dominant language of health science research. The main advantages of English being dominant are that there is a common language for science and it has extensive technical vocabulary in many disciplines. The main disadvantage is that English is a requirement for researchers to use for reading, writing and verbal communication in order to succeed internationally. Findings concerning the intersection of non-language barriers with language include the following: • Gender may intersect with language and other individual characteristics to multiply/compound vulnerabilities, especially for women. • Access to interventions that aim to address language barriers is gendered. • There was consensus among participants that financial barriers significantly impede both advancement for researchers at the individual level, as well as for broader scientific advancement in health
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